Treatment Options for Clinical Pain

8/6/2019 Treatment Options for Clinical Pain

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Treatment Options for Clinical Pain

Joy Wilson07/26/2011

Facilitator: Diane Phillips


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Treatment Options 2

Pain that requires and benefits from medical treatment is called clinical pain

(Sarafino, 2000). There are many medical situations and conditions that require

treatment of acute clinical pain. A patient stress and emotional level can be improved

with the proper treatment of acute pain. When a patients pain level is alleviated or at a

comfortable level, the patient tends to be more at ease and able to function better. To

completely eliminate chronic pain may require a more aggressive and comprehensive

plan of treatment. An aggressive and comprehensive approaches used in cases like this

may include the multiple or combined approaches, consisting of pharmacological,

behavioral, cognitive, and surgical treatments which are designed to have the greatest

benefit for each individual patient (Sarafino, 2006).

There were three cases presented. Each case show be viewed and evaluated

individually for potential approaches of clinical pain treatment. There are four

approaches which include behavioral and cognitive therapies. These approaches will

give the patient the proper tools and knowledge for coping with chronic clinical pain;

medications; and surgical treatment for reducing or eliminating pain (Sarafino, 2006).


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This assignment required that we take a look at three different of clinical pain. The first

case discussed a patient suffers from clinical pain that resulted from a below the knee

amputation. In the second case we examine an individual who has post-operative acute

pain from an abdominal hysterectomy. In the third case the individual complained of

chronic headache pain that was not diagnosed as migraines (Axia College, 2007).

In the first case it was easy to identify that the cause of pain resulted from the

phantom limb which is often a part of amputation (Sarafino, 2006). The patient should

be evaluated to assess the possible underlying causes of the patients pain. One

suggestion could be that a prosthetic limb does not fit properly. This can possibly cause

the site of amputation to become irritated and uncomfortable. Another possible cause

could be that the patient is not being receiving enough physical exercise, which can

cause stiffness and irritation. In this patients case, surgical treatment wouldnt be

recommended (Nelson-Hogan, 2007). The patient would probably benefit from short-

term pharmaceutical treatment along with cognitive and behavioral therapy.

In the second Case the patient was experiencing acute post-operative pain,

which may possibly require short-term pharmaceutical treatments for alleviating pain

and discomfort that follows post major surgery. The approach to treat this type of pain

could be as aggressive an additional surgery to alleviate the pain, or a minimal approach


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like cognitive and behavioral therapy (Sarafino, 2006).

It is not likely doctors would recommend surgical treatment is for the patient in

the third case. The patient complains of suffering from chronic headaches. The

headaches are more than likely the result of tension or stress (Serafino, 2006). Using

pharmacological treatment for pain control should be used only in cases of severe,

prolonged, and frequent headaches. Cognitive and behavioral approaches could be

highly beneficial. Stress is a part of everyday life, but the reduction of stress can help

reduce or even eliminate the frequency of headaches (Sarafino, 2006)

The patient with clinical pain due to recovery from an abdominal hysterectomy

will have her pain reduced or alleviated by using centralized pain medications, the

reason being they are the most effective for treating severe acute pain (Sarafino, 2006).

The patient can receive hydrocodone, codeine, morphine, Demerol, or dilaudid

intravenously while an inpatient (Hanley Center, n.d.). Once discharged from the

hospital, the patient can continue reducing any post-operative pain by using oral pain

medications like Percocet, vicodin, or codeine. This will also help with the reduction of

inflammation and swelling at the surgical site (Hanley Center, n.d.).

While the patient is still an inpatient, she should receive cognitive training

concerned with redefining pain as a way to cope with acute pain following her surgery


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(Sarafino, 2006, p.332). If she does not comply with her care after surgery, an operant

approach needs to be put into place. Complying with post surgery care is a major factor

in recovering from pain after surgery. Not following the doctors recommendations after

surgery may possibly result in prolonged pain after surgery, infection, or other

complications. This patient will benefit greatly from following the doctors post care

orders and taken the prescribed pain medications.

The case of treating pain for the amputee can potentially be more difficult and

may require more than one forms of treatment. This patient may benefit from the

services available at a pain clinic. Amputation may not only affect the patient

physically, but psychologically as well. In situations like this the patient may benefit

from group therapy along with the pain medications. In this approach the patient can

relate to other sufferers of chronic pain and other patients that are also dealing with the

post affects of amputation. At group therapy sessions the patient will have the

opportunity to hear other peoples stories, and the mechanisms they use to cope with

stress and pain, which may leave a positive impact on the patient. The patient can also

have a more positive outlook through redefinition (Sarafino, 2006).

Along with therapy the amputee may also benefit pharmacological help with

treating pain. If the patient is suffering from depression, he or she may also prescribed


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an antidepressant along with the pain medication, can reduce the likelihood of

depression as well as pain, and can help aid the patients ability to sleep. A sedative

antidepressant that also contains analgesic properties can address several of the patients

complaints (Nelson-Hogan, 2007). There have been cases where a combination of

antidepressants and methadone successfully has treated phantom limb pain (Sarafino,

20060. I believe this patient will benefit from oral pain medication, group therapy

treatment, as well as an antidepressant. This will be a major factor for managing the

case of the amputee.

Depending on the effectiveness of the pharmaceutical, cognitive and behavioral

approaches to pain management, a TENS unit or massage therapy could also be

beneficial (Sarafino, 2006). Examining the patients prosthetic limb for fit issues will

address any problems that may be adding to the patients chronic pain and distress

(Nelson-Hogan, 2007).

The patient with chronic headaches is far more complex. Likely, social factors

are a major contributing cause of this chronic pain. Stress from life circumstances, such

as relationships, likely causes muscle and tendon tension. This patient needs extensive

cognitive and behavioral methods of treatment. No surgical treatment is needed.

The patient will also need psychotherapy to help him or her learn how to cope


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well with stress and how to relax. Biofeedback, along with an operant approach to

therapy, will also be utilized (Sarafino, 2006). For this patient, I anticipate biofeedback

to have great benefits, as it has been proven to be 40% to 50% effective in reducing

tension-type headaches (Sarafino, 2006). The uses of imagery to bring on relaxation, as

well as redefining pain, are among the cognitive approaches to be used (Sarafino, 2006).

Referrals to massage therapists or acupuncturists can help the patient in pain reduction

and increase of relaxation (Sarafino, 2006). Additionally, the patient will assess personal

levels of physical activity and create a regular routine of exercising as a means of

reducing the effects of stress.

Although these may have been three different cases that did not require the use

of surgical treatment for the reduction or elimination of clinical pain, this is an

appropriate option for certain kinds of pain and should always be considered as such.

All four types of treatmentbehavioral and cognitive, pharmacological, and surgical

approachesmust be carefully evaluated during the development of a treatment plan

for a patient with clinical pain. A complete, inclusive approach made up of multiple


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approaches is the one most beneficial for treating pain.

References

Axia College. (2007). Treatment options for clinical pain. Retrieved May 28, 2009,

from

Axia College, Week Seven, HCA250 - The Psychology of Health.

Hanley Center (n.d.). Managing post-surgical pain for those in addiction recovery.

Retrieved May 28,2009, from

http://www.hanleycenter.org/pdfs/postSurgicalBrochure.pdf
http://www.hanleycenter.org/pdfs/postSurgicalBrochure.pdfhttp://www.hanleycenter.org/pdfs/postSurgicalBrochure.pdf


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Nelson-Hogan, D. (2007). Diagnosis and treatment of post-amputation pain. The Pain

Practitioner, 8-11.

WebMD. (2010).Pain and Depression. Retrieved from

http://www.webmd.com/painanddepression

Sarafino, E.P. (2006).Health psychology biopsychosocial interactions (5th ed.).

Hoboken, N.J.John Wiley & Sons.
http://www.webmd.com/painanddepressionhttp://www.webmd.com/painanddepression

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Treatment Options for Clinical Pain